Recent Progress in Gynæcology

1879 Boston Medical and Surgical Journal  
The readiness with which the profession have adopted Lister's method and applied it to ovariotomy since the first regularly published case by Dr. Sims in the New York Medical Record of December 2, 1876, shows the importance with which it is regarded ; and there can scarcely be a question at this day that it is the most progressive step which has been taken for some time in the treatment of this highly important branch of gynaecological surgery. We can perhaps better appreciate its importance
more » ... n we consider the success which has so repeatedly attended this method of treatment, even in the general hospitals and surgical wards, where we should expect to obtain only the worst results, and where formerly only death awaited those who were operated upon under its influences. Even among those who have proved themselves the most successful in performing this operation the importance of using the above method more or less perfectly has been felt ; the same cases which have heretofore been considered as making a good recovery with the aid of means to lower the temperature of the body now recover, when treated antiseptically, without the use of any such means. Prof. T. Spencer Wells, in a lecture delivered at the Royal College of Surgeons of England, and reported in the British Medical Journal of July 20, 1878, refers to this subject in the following words : " I may say that, in antiseptic ovariotomy, fever is the exception, whereas formerly it was the rule." The strongest objection which has been raised against the antiseptic treatment in ovariotomy is the chilling influence of the spray. That this is considered so serious an objection that this part of the method is omitted by some prominent ovariotomists we are well aware. We also learn from the report of the lecture already referred to that Mr. Wells had entertained the same doubt as to the advisability of exposing the abdominal cavity to this influence. From the opinion of Mr. Lister himself, however, in regard to its necessity, in support of which Dr. Keith says his trials before using the spray were much less satisfactory than they have been since, and confirmation of which we doubt not would be found in the experience of a score of operators in this country, we feel assured in insisting upon this part of the method, confident that when the fact of its necessity is once received, its objectionable points will be greatly diminished by the increased care which will be given to the protection of the abdominal cavity and its contents when it becomes advisable to enlarge the original incision. The minor objections of the increased trouble which the spray occa-
doi:10.1056/nejm187901231000405 fatcat:rnjqresd6jgfxml6kvhchjrzki